Francisco Marty, MD Profile picture
Infectious diseases doctor who specializes in treating transplant and cancer patients, forged at @UCV_noticias, @EinsteinMed, @BrighamWomens and @DanaFarber
Antonio Antela Profile picture Mariajesus Dominguez Profile picture 3 subscribed
Mar 9, 2021 20 tweets 14 min read
Finally got to analyze & put my thoughts together on the recent #posaconazole vs. #voriconazole phase 3 trial for invasive #aspergillosis published in .@TheLancet a few weeks ago.
Best is to put the major trials of the 3 #VIP triazoles done over the last 20 years in perspective! So (re)studied the following key trials & appendices

#Posaconazole vs. #Voriconazole: thelancet.com/journals/lance…

#Isavuconazole vs. Vori: thelancet.com/journals/lance…

#AmphotericinB vs. Vori: nejm.org/doi/10.1056/NE…

#TxID #IDTwitter
Jan 25, 2021 7 tweets 8 min read
To cap a weekend of #colchicine-induced GI upset from the press release of #ColCorona trial relative %s approaching statistical significance for #COVID19... started getting messages regarding #Maduro's announcement this evening of #Carvativir, Jose Gregorio's miraculous drops He plans to distribute the new wonder anti-#COVID19 treatment widely throughout #Venezuela this week. He mentioned the drug is given as drops sublingually every 4 hours...

efectococuyo.com/salud/carvativ…
Dec 21, 2020 25 tweets 28 min read
It took a while to digest the details of over 600 pages, but here is my review and comparative analysis of the #ACTT2 trial that compared #baricitinib vs. #placebo among patients receiving #remdesivir for #COVID19!

Some very interesting insights, I think!

Sit briefly and enjoy! Will be mainly comparing #ACTT2 to #ACTT1, but also will get some insights and questions that come up when comparing #ACTT2 to the #dexamethasone #RecoveryTrial
Dec 9, 2020 39 tweets 25 min read
With the .@NIAIDNews #ACCT1 trial final report published on 05 Nov 2020 and the .@WHO's #SolidarityTrial Preliminary report published on 02 December 2020, thought it would be good to take another look at both trials and find ways forward for the patients we are dealing with today Motivated by a patient I am dealing with who will survive very severe #COVID19 in the setting of transplant, but her father, who was hospitalized earlier than her with moderate COVID, was left to progress and died before her discharge, given #remdesivir only after going on #BiPAP
Oct 20, 2020 26 tweets 16 min read
Time to share some thoughts and questions following the .@medrxivpreprint first release of results from the #SolidarityTrial that compared local standard care to #remdesivir, #HydroxyChloroquine #lopinavir_ritonavir and #interferon for treatment of patients with #COVID19 I have read the #solidarityTrial preprint: medrxiv.org/content/10.110…

Its supplementary material:medrxiv.org/content/10.110…

its posted protocol: who.int/publications/m…

The CRF: who.int/publications/i…

The final report from #ACTT1 for contrast: nejm.org/doi/full/10.10…
Aug 12, 2020 21 tweets 20 min read
Posting some reflections on the #ACTT & #RECOVERY trials related to #remdesivir & #dexamethasone for the treatment of #COVID19

Those results feel like definitive advances, but we need to realize their limitations and need for confirmation despite everyone's #pandemic fatigue

1/ Image There are lot of skeptics in and outside of #Twitter on the results of both trials, strong emotions regarding big-pharma made medications, the way the #EUA was made, also about use of #steroids in the #ICU that has a quite rocky history among those who run those units.
Jun 17, 2020 12 tweets 13 min read
Updated the #RECOVERYtrial topline results summary table of the #dexamethasone arm compared to usual care for treatment of hospitalized patients with #COVID19.

Got additional information colleagues shared in Twitter.

Thread with some comparisons with #ACTT1

#IDtwitter 1/ the #ACTT1 authors have only reported (preliminary) Day 14 mortality, and the #RECOVERYtrial has only posted Day 28 mortality.

But these days the Supplementary Appendices in trial reports have additional relevant information:
nejm.org/doi/full/10.10…

#DontCoverDiscover
Jun 16, 2020 11 tweets 9 min read
Tabulated the topline results released by the #recoverytrial team on #hydroxychloroquine & #dexamethasone, and went over their protocol (recoverytrial.net/results) to better digest them.

Basic stuff:
- hospitalized patients @ 175 NHS centres
- open label, 5 initial arms
- thread— Important point from #RECOVERYTrial protocol

- if a patient had a #contraindication to one of the intervention arms, according to the clinical care team at the site, that particular arm was not available to that patient at the time of #randomization
May 5, 2020 13 tweets 12 min read
#Remdesivir begins distribution in the #USA today via #EUA.

I thought would write down some practical #tips based on my #qualitative anecdotal experience after personally treating close to 200 patients with #COVID19.

For quantitative results, wait for the papers¬—thread “this juice works, doc!” When you hear similar expressions 1-2 days after starting #remdesivir multiple times, you start to wonder. Don't recall a similar proportion of patients smile after feeling so sick 1-2 days earlier with #COVID19. x/n? Wait for the papers.
May 1, 2020 12 tweets 8 min read
Lots of colleagues & friends remain sore after the #FauciLeak on the interim #ACTT trial analysis that compared #remdesivir to placebo in patients hospitalized with severe #COVID19 2 days ago.

My thoughts on the events as a #clinicaltrials and #DSMB doctor—thread 1/10 Data Safety Monitoring Boards (#DSMB) are independent groups of doctors & statisticians that analyze unblinded data in clinical trials, key to assure safety of patients enrolled, think about it as a safety satellite or control tower for the blinded investigators & patients.